Healthcare Provider Details

I. General information

NPI: 1003077355
Provider Name (Legal Business Name): ANGELA ESCOBAR SEDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA JILL ESCOBAR M.D.

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 W RANDOL MILL RD STE 200
ARLINGTON TX
76012-2510
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 817-261-4906
  • Fax: 817-261-5837
Mailing address:
  • Phone: 972-997-8000
  • Fax: 972-234-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR-8415
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberP8618
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberP8618
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: